By: Ni Made Dwi Suparningsih  Immediately post-coitus

 Type of emergency contraceptive ;

Contraceptive for ♀ > 35years 1. Mechanical (IUD)→ best used within 5-7
days of unprotected sex.
 Contraceptive ♀ > 35years → need safe and 2. Medical → best used within 3 days of
effective (High risk). unprotected sex ;
 Combination birth control pill and Pill (High dose) → 2 x 2 tablet
combination birth control injection/shot → (microgynon50, ovral, neogynon, nordion,
more safe if there no other risk factor. eugynon)
 Being Smoker not recommended for use of Pill (Low dose) → 2 x 4 tablet
combined pill/shot. (mycrogynon30, mikrodiol, nordtte)
 Progestin contraceptive can be used by ♀
>35years and smoker. Cotraceptive Method
Contraceptive for Postpartum
A. Lactational Amenorrhoea Method
 Rely on breastfeeding
 Infertility postpartum who haven’t  If full breastfeeding more than 8 times
breastfeeding average 6 weeks, for
 Mens-period haven’t resumed
breastfeeding longer.
 The infant is under 6 monts of age
 Lactational amenorrhoea method (LAM) if:
 Effective until 6 months.
1. Mens-period haven’t resumed
 Suppress of ovulation
2. The infant fully breasted frequently/more
B. Natural family planning
than 8 times (on demand)
 Fertile period ; Longest cycle (-11);
3. The infant is under 6 month of age
shortest cycle (-18)
 The recommended time to begin
1. Ovulasi Billings method
contraceptive when breastfeeding ;
2. Simptothermal method
1. Immediately (Barrier, LAM)
3. Calender method/pantang berkala
2. 3 weeks (IUD)
4. Basal Temperature method
3. 6 weeks (Permanent contraceptive and
C. Combination birth control pill
Progestin contraceptive)
 Can used for emergency contraceptive
4. 6 months (Combined contraceptive)
 Not recommended for breastfeeding
 The recommended time to begin
contraceptive haven’t breastfeeding ;
1. Immediately (Barrier, Progestin) Mechanism;
2. 3 weeks ( IUD, Combined)
3. 6 weeks (Permanent)  Suppress ovulation
 Prevent of implantation
Contraceptive for Post-Abortion  Thicken the cervical mucus
 Immediately ( Combined pill/shot; progestin;
Type of;
implant,)
1. Monofasik ; esterogen and progesterone
 Recommended on TM1 → interval period
within same doses
 Recommended on TM2 → Postpartum period
2. Bifasik ; esterogen and progesterone
 IUD (TM1→immendiately; TM2→4-6 weeks)
within different doses
3. Trifasik ; estrogen and progesterone
Emergency Contraceptive within 3 different doses
(Morning after pill; morning after treatment) The advantage;
1. High effectiveness such as tubectomy
2. Prevent to anemia D. Combination birth control injection/shots
3. The fertility back soon  Contain (25mg-Depo
4. Used to emergency contraceptive Medroksiprogesteron As. & 5mg-
5. Stopped any time Estradiol Sipinoat)→every 1 month
6. Not interfere sexuality (Cyclofem)
7. Prevent some disease (Cancer, KET)  Contain (50mg-Noretindron Enantat &
5mg-Estradiol Valerat)→every 1 month
Disadvantage ;
1. Expensive The mechanism ;
2. Nausea
3. Spotting  Supperssing ovulation
4. Headache  Thicken servical mucus
5. Breast pain  Infertere implantation
6. Not recommended for breastfeeding
Advantage ;
(decreas of ASI)
7. Not prevent for IMS
 Prevent anemia, KET, Ca
The recommended ;  Decreas pain, blooding

1. All reproductive have/haven’t of chidren Disadvantage ;

2. Not breasfeeding postpartum
 Spotting
3. Post-abortion
 Not prevent for IMS
4. Anemia
5. Period-pain  Fertility restoration longer
6. Irregular period  Weight gain
7. KET  Side effect (stroke, heart attack)
8. Disrorder breast benign  Dependence of health care
9. Diabeth
The recommended ;
10. PID, Tyroid, TBC, Varices
1. All reproductive have/haven’t children
Not Recommanded ;
2. Breastfeeding > 6 month
1. Breastfeeding 3. Not-breastfeeding
2. Smoker 4. Anemia
3. Heart, stroke, Hyper >180/110 5. Disminorroe
4. Breast cancer 6. KET history

The time to start using comination pill ; Not recommended ;

1. Every time while menstrual-period 1. Breastfeeding , 6bweeks

2. 1-7 days of menstrual-period 2. Unknown bleeding
3. Postpartum; 3. Storke, heart,
- 6 month breastfeeding 4. hyper >180/110
- 3 month not breastfeeding 5. Breast ca
4. Post-abortion within 7 days
The time to start using comination shot ;
The instruction ;
1. 1-7 days of mens-period, ; > 7 days not
1. To recommended used within 1-7 days recommended for sexual within 7 days ;
menstrual-period. if haven’t period → every time if haven’t
 pregnant and not recommended for  Cannot stopped any time before the
sexual within 7 days (an other next shot
contraceptive)
 Spotting
2. 6 month postpartum and breastfeeding
3. > 6 month postpartum, breasfeeding  Haven’t mens-period
and have period  Weight gain
4. 3 month postpartum and not  Not prevent for IMS
breastfeeding  Fertility restoration longer
5. Post-abortion
 At long time have decrease of bone
E. Progestin Contraceptive shots dentisty, libido, headache, acne
 High effective
The recommended ;
 Safe
 All reproductive 1. Reproductive; Have and Haven’t
 Fertility restoration longer (± 4 month);
children
DMPA (10 month); NET-EN (6 month)
2. Breastfeeding
 Recommanded for breastfeeding period
cause cann’t suppressing ASI 3. Postpartum and not breastfeeding
4. Post-abortion
Type of ; 5. Grandemulti
 DMPA ( Depo MedroksiProgesteron 6. Smokers
Asetat)- 150 mg ; every 3 months 7. Hyper <180/110
 NET-EN (Depo Noretirteron 8. For user of epilepsy/TBC
Enantat/Depo Noristerat)- 200 mg; every 9. Cannt using of estrogen
2 months 10. Anemia
Mechanism ;
Not Recommanded ;
 Prevent of ovulation
1. Pregnant
 Thicken servical mucus
2. Unknown bleeding
 Make uterine mucus more slight 3. Breast cancer
 Infertere gamet transportation 4. Complicated of diabet
Advantage ; The time to start using of progestin
contraceptive shot ;
 High effective
 Not contain of estrogen → nothing 1. 1-7 days of period
impact for heart and coagulation blood 2. Anytime who haven’t period, after 7 days
disorder not recommended for sexuality
 Haven’t effect for ASI 3. For IUD → 1-7 days of period
 Decrease of binign breast, anemia
 Prefent to PID, Ca How to use of Progestine shot ;

Disadvantage ;  DMPA ; every 3 months

 NET-EN ; every 2 months/8weeks untul
 Perio disorder found 4 times,,the fifth shot and the next 3
 Dependence of health care months/12 weeks
 An other information ;  Don’t forget to use (at night)
 The sexuality should be 3-20 hours after
 Often cause amenorrea used
 Weight gain, headache, chest pain
 The fertility restoration longer The advantage ;

To handling of disorder of period; 1. Safe for breastfeeding

2. The fertility restoration quick resumed
Amenorrea; need only counseling 3. Not contain of estrogen
4. Decrease of pain, period bood, anemic,
Bleeding ; if bleeding countiues have to PMS
found the causes of; if the bleeding > 8 days 5. Prevent of PID
or 2 times more than before within normal 6. Can used for endometriosis
cycle its normal on 1 month shot Disadvantage ;

For the attention ; virus (hepar), heart and 1. Bleeding disorder

stroke not to recommended to use shot 2. 1 pill lose ; filed
contraceptive. 3. Strained breast, nausea, headache,
acne
F. Pill Progestin / Minipill 4. High risk of KET
 Recommanded for breastfeeding 5. The effectiveness lower for TBC
 Very effective for breastfeeding 6. Not prevent for IMS
 Low doses
The recommended
 Not to decrease ASI Product
 Not show like the estrogen 1. Reproductive age
 The main side effect ; spotting, disorder 2. Breastfeeding
bleeding, irregular bleeding 3. Smokers
 Can used for emergency contraceptive 4. Hyper (180/110)
5. Not recommended for estrogen
Type of ;
Not Recommanded ;
 35 pill ; 300miug levonorgestrel/350miug
noretindron 1. Pregnant
 28 pill ; 75 miug desogestrel 2. Unkown bleeding
3. Confuse of disorder mens-period
Mechanism ; 4. Using TBC Medicine/epilepsy
5. Breast ca.
 Suppressing secretion of gonad and
6. Stroke
synthesis of sex steoid in the ovarium
 The transformation of endometrium The time for using Minipill
faster so that the implantation more
difficult  1-5 days of period
 Thicken the servical mucus  Anytime ; if used 5 days not for
 Change of motility tube so that the recommended sexuality within 2 days
tranfortation of sperma disorder (another contraceptive)
 For breastfeeding ; between 6 weeks-6
The effectiveness ; months
 Post-abortion ; immediately
 High
 If change using shot to minipill Disadvantge ;
recommended to using on the next
schedule of shot  Changes of mens-period
 Spotting
The Instruction for client :  Hypermenorroea, Amenorroea
 Headache, weight, breast-pain,
1. To use at the same time
 Nausea
2. First pill at first period
 Require of minor surgery
3. If forget use another contraceptive
 Not for free-sex

The recommended
Implan Contraceptive
1. Reproductive age
 High effective
2. Have/not of child
 Norplant →5 years
3. Require of long term contraceptive
 Jadena/Indoplan/Implanon→ 3years 4. For breasfeeding
 The fertility immediately resumed 5. Postpartum and not breasfeeding
 Side effect ; irregular period. Spotting; 6. Post-abortion
amenorroea 7. Unwanted pregnancy but not ready for
 Recommended for breastfeeding permanent
8. KET-History
Type of ;
9. Hyper<180/110
10. Not recommaned for estrogen
 Norplant ; 6 silastik stick; 36 mg
11. Often forget to use pill method
levonorgestrel
 Implanon ; 1 flexible white stick; 68 mg Not for Recommended
3-keto desogestrel
 Jadena & Indoplant ; 2 stick; 75 mg 1. Pregnancy
Levonorgestrel 2. Unkown bleeding
3. Benign/ca. breast history
Mechanism ;
Time
 Ticken the servical mucus
 Interfere of endometrium synthesis 1. 2-7 days
procces to difficult of implantation 2. >7 days not to recommende for sex
 Decrease of sperma transportation 3. Breasfeeding 6week-6month
 Suppressing ovulation 4. If b4 using shot implant can used accord
the schedule
Advantage ; 5. Postpartum
6. From AKDR ; 7days and not
 High efficiency recommended to sex
 Long term protection
 The fertility immediately resumed Instruction
 Free-estrogen
1. Keep the insertion
 Doesn’t require of toucher
2. Side effect of the insertion
 Not interfere sex, ASI 3. The bandage opened >48hours
 Can stopped anytime 4. Storm warning of insertion
 Decreases of pain, blood count, anemic, 5. Explain about ; effectiveness ; period
another benign, endometriosis disorder 6-12month
 protect of endo.ca, PID